Medications are effective in about 70% of patients with essential tremor and work well for most with Parkinson’s disease (PD). Many patients with essential tremor, however, are unable to complete activities of daily living with ease even with the use of medications. In people with PD, symptoms worsen over time despite medication. For these patients, successful symptom treatment may be found in deep brain stimulation (DBS). Approved by the FDA in 1998 to treat essential tremor and again in 2002 for PD, DBS involves implanting electrodes in the deep part of the brain. The electrodes are connected to a wire tunneled under the skin to a battery that is implanted just under the skin in the chest. It essentially acts like a pacemaker for the brain. While it’s unclear exactly how DBS works, it appears that electrical stimulation overrides abnormal signals in the brains of patients with PD and essential tremor. Identifying Ideal Candidates for DBS For many individuals with PD, medications may only suppress symptoms for a short time, forcing patients to take their medication more frequently as they wait for the next dose to kick in. In these cases, physicians should consider DBS. Other beneficiaries of DBS include those with PD for whom medications are completely ineffective for reducing tremor. Research shows that only 50% to 70% of patients with essential tremor respond well to medication. Those who don’t respond typically suffer from a poor quality of life and should be considered candidates for DBS. Contraindications to DBS include significant cognitive problems and uncontrolled depression. Getting the Word Out About DBS Despite a decade’s worth of experience,...